thyroid resistance please help???

[sandyg23]

  I am a 48 year old female.   When I was 26 years old I was diagnosed with Graves Diseasse.  I had RAI done.   I was on 150 synthroid and then it 2007 it was uped to 200 synthroid.   3 years ago I went to my OBGYN in November and my thyroid was perfect.   In December I had a trama.   Within 24 hours my life changed.   I was scared to leave the apartment, I was retaining fluid,  I was unable to live.   I went to the doctor who was unable to see me but the PA was.   The PA advised I was not converting t4 to t3.   She placed me on armour and wanted me to follow up with an endo.   I went back to the endo that did my RAI.   He advised me that was crazy and I better get back on the Synthroid.   I continue to go down hill.   I had a hard time seeing.   I could not drive very far.   I ended up with a serious rash all over my body.   At this point the doctor hopping started.   I was told that everything was in my head and then sent to a doctor who put me on lexapro and xanax.   I have been off of that for 6 months.   They made my condition worse.   I went to another doctor 2 weeks ago.   They ran blood work at this was my results.

TSH 12...6. 22 range 0.4- 4.5
T4 1.1 range 4.5- 12.0
T4 free 0.4 range 0.8-1.8
T3 free 0.6 range 2.3-4.2
T3 total <25 range 76-181
T3R <5 range 11-
Doc said she had never seen anything like this.  Saw an endo friday said they can not help me I am thyroid resistance.  Referred me to ut southwestern can not get in till Oct.  Please Help

[sandyg23]

Dr. Lupo

I am sorry that was a mistyped....my tsh on those labs was 126.22 and in April was 166.


Thank you for your help
Sandy Hilty

[sandyg23]

Thank you for your answer Dr. Lupo.   I only take synthyroid and I take 1200.   I dont take any other medications.   In april my tsh was 166.   It seems not doctor can figure out what is going on.   I dont take t3 and cant get a doc to perscrip it for me.  I want to try Triosint.   I am trying to get a doc to give it to me.   I dont see any harm, it only could help.   NIH is doing a study on this, trying to get doctors to write letters to try and get into it.   What type of doc would you suggest I go to, since I have been to reg mds and endos with no luck.   Thank you for your time.
Sandy Hilty

[Mark Lupo, M.D.]

This is not thyroid hormone resistance (which would give high TSH and high T4), but is unusual.  There is likely an absorption problem (which may be what the endo meant by "resistance").  You may need a GI evaluation to sort that out, but I have had some success with changing to a brand called Tirosint which is a T4 product w/o fillers and is gel-based.  I am not sure what dose you were on with the labs you posted, but the TSH of only 12 with T4 and T3s that low suggests a slight possibility of pituitary disease or recent T3-only dosing which you stopped a few days prior to the testing.  Most commonly this would be an absorption issue -- gastroparesis, gastric bypass, celiac sprue, inflammatory bowel disease, medication/supplement interference.